So you’ve received a dental referral, now what?
A dental referral is a recommendation from one dental professional to another, typically for specialized care or services beyond the scope of general dentistry. This process ensures patients receive the most appropriate and expert treatment for specific dental issues, leading to comprehensive oral health care.
Do you know what your options are regarding a referral? Do you know if the dentist or doctor you’ve been referred to is in your Delta Dental network?
We’re here to help guide you through some common referral questions.
Why am I being referred to a specialist?
This is a question that can only be answered by your dentist. They can provide information on what procedure they're recommending and why another provider is necessary for it.
Is my referral in-network?
Not necessarily. Your dentist will refer you to a known specialist or associate but that doesn’t mean they verified the referred provider is participating with your dental plan. The best place to start when receiving a referral is to understand if that provider participates with Delta Dental.
Does seeing a dentist on referral cost more?
Your out-of-pocket cost will depend on your Delta Dental plan and if the dentist you are referred to participates in your network. Choosing an in-network provider, whether they are your primary dentist or one you visit on a referral, will often save you money and maximize the value delivered by your Delta Dental plan. We strongly encourage you to ask for a pre-treatment estimate for the services being recommended so that you are aware of your out-of-pocket expense.
Also be aware that some oral procedures may be considered a medical procedure rather than a dental procedure. In this case, your health care coverage may be involved in your treatment. A pre-treatment estimate can help identify procedures that are not covered by your dental benefits.
Do I have to visit the specialist my dentist recommended?
No. Which specialist you visit, is up to you. You may schedule an appointment with the specialist you have been referred to, or there may be other specialists in your area that participate with Delta Dental.
If you need assistance finding additional provider options, use the Find a Dentist tool to search for providers, including specialists, near you. You can filter the results by specialty to find a provider who matches the procedure for which you've been referred. Using an in-network provider often saves you money and will maximize the value delivered by your Delta Dental plan.
You can also visit the Member Portal to find providers as well as information about your Delta Dental plan's benefits.
What are dental specialists and how do they differ from general dentists?
Your referral should indicate the type of dental specialist to whom you are being referred. Common dental specialties include:
- Endodontist: This specialist is focused on diagnosing, treating and preventing infections and injuries in the dental pulp or the nerve of the tooth.
- Orthodontist: An orthodontist provides teeth straightening by moving them through the bone structure with the use of braces or other corrective appliances.
- Periodontist: This specialists is focused on soft tissue (gum) diseases of the teeth, as well as the supporting structures (bones) of the teeth.
- Prosthodontist: A prosthodontist focuses on cosmetic dentistry, dental implants, crowns, bridges, dentures and related procedures.
- Oral and maxillofacial surgeon: This specialist is a trained surgeon who focuses on correcting medical issues of the mouth and face.
- Oral and maxillofacial radiologist: This is a dentist specialized at reading and using radiographic images to treat diseases of the mouth and jaws.
- Pedodontist: A pediatric dentist that specializes in working with infants and children.
Use this checklist when you receive a dental referral:
- Understand the procedure you’re being referred for.
- Call the provider or use the Find a Dentist tool to verify if the dentist participates with Delta Dental. The tool can also be used to search for other potential specialists near you that participate with Delta Dental.
- Request a pre-treatment estimate from the specialist to verify any out-of-pocket cost.
- Choose a specialist.
- Schedule an appointment.